RAVEN Report: Went Live, Now What?

The RAVEN Go-Live date has come and gone; the solutions are still in place and the world as we know it at YKHC did not end at the stroke of midnight on January 28, 2013. In short, things went incredibly well as we “turned on” our Electronic Health Record system: Records And Verification Electronic Network.

“Many people working closely on the transition to Go-Live were extremely optimistic from the get-go,” said RAVEN administrator Karl Powers. “The date of Go-Live has been well known across the organization for over a year.” Employees as well as patients have been kept in the loop and should be prepared for a change.

Many of the 70 or so employees of Cerner, YKHC’s vendor partner for the EHR project, who were on site for Go-Live commented on how well it went. According to YKHC’s Director of the Office of Environmental Health & Engineering (OEHE) Brian Lefferts, who spent a lot of time with support functions for the hospital during the critical preparations, one Cerner employee said that it was “in his top three” for smoothest transitions and preparations ever—mostly on account of the tremendous staff support functions put in place for users.

YKHC Medical Director Dr. Joseph Klejka, who oversees the IT Department, said, “We know that there are still numerous outstanding issues, which we are working on. Our goal still remains the same, however: focusing closely on critical access and critical patient safety measures first…and fix any bugs as soon as they present themselves as quickly as possible.”

Susan Wheeler, a long-serving YKHC pharmacist and key administrator in the RAVEN project, said, “the YKHC staff, RAVEN implementation team, CHA/Ps and Basic Training Instructors should be commended as it was truly a comprehensive approach that everyone was involved with to some degree or another. There was a ton of information and training that was poured into six weeks that YKHC staff had to know and learn prior to Go-Live.”

Employees who worked closely with the preparations spent long days, including weekend hours, on RAVEN. There was time away from families, middle-of-the-night calls, and other sacrifices. An estimated 13,000 staff hours were dedicated to preparing for Go-Live.

Wheeler said, “We should really commend our patients, especially for the first week of Go-Live, as they were extremely patient in adapting to the new system. They didn’t complain and understood we were venturing into a new realm from everything to scheduling and registration, to obtaining lab results, or even getting their prescriptions filled.”

Wheeler mentioned one patient in particular whose own unique situation resulted in a normally 15-minute procedure lasting more than an hour. But the patient was “patient” as wrinkles in the new system were ironed out.

What else can patients and customers expect at YKHC as a result of the RAVEN implementation?

As for Pharmacy, Wheeler said, “people may be wondering where the big TVs went.” Also known as the Notice Board, patients’ encrypted names would pop up on a TV screen. No longer, at least for now. For the time being, the pharmacy clerk will notify patients by calling out names for medication pick-ups or refills as the Pharmacy team looks for a better method of notification.

Patients waiting for a pharmacy order are encouraged to engage with providers at a higher level, or notify the Pharmacy staff that the medical provider requested a prescription or refill, and that they are physically present to pick it up. This way their refills can be ‘promoted’ in the RAVEN system.

What happened to the paper medical charts?

Paper charts are not going away entirely at the moment. Many providers will have both the paper chart and perhaps a laptop or a computer console on hand so they can reference a patient’s medical history (i.e. surgery history, pre-existing conditions, allergy information) and compare this with relevant information that must be entered into the electronic version of the medical chart.

What else is so special about RAVEN?

The RAVEN system will improve a patient’s experience from the village clinic level all the way to the Bethel hospital’s Emergency Room. Many ER providers have experienced the frustration of a patient arriving on a village medevac without complete documentation. Now, this is not the case. When a patient has an encounter with a Health Aide in a village, that information will reside in RAVEN, and if the patient is referred to a higher level of care, or is sent to Bethel’s Emergency Room, the information is logged and tracked in the new RAVEN patient charting and documentation system. There will not be time wasted tracking background or medical history because it will all reside in one place.

How will new providers, doctors, nurses and staff learn the new RAVEN system?

The RAVEN team is working on what’s called Learning Live. It’s a forum where new staff can access job aides and RAVEN training materials specific to their key functions, department, and job duties. The RAVEN team has a Change Management committee in place to make sure system upgrades are comprehensive and functional.

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